Hematological biomarkers in Ankylosing Spondylitis patients and its relation to disease activity

Background: Some hematological indices can be used in assessment of disease activity in autoimmune diseases as spondyloarthropathy. The aim of this work is to determine hematological changes in ankylosing spondylitis and their relationship to activity. Patients and methods: The current study included 20 AS patients and 10 as control. The disease activity was evaluated using the Ankylosing Spondylitis Disease Activity Score (ASDAS). Various indices and characteristics related to complete blood counts were evaluated. Results: A total of 20 AS patients and 10 age- and sex-matched controls were included. The median age of AS patients was 44 years, with 81.3% males, and a median disease duration of 7 years. ASDAS categories revealed 3 patients with inactive disease, 8 with very high disease activity (VHDA), and nearly equal numbers with low disease activity (LDA) and high disease activity (HAD) (5 and 4, respectively). Significant differences were observed between patients and controls in MCV, MCH, MCHC, MPV, RDW, MLR, NLR, and neutrophil and monocyte counts. ASDAS was significantly correlated with Hb, HCT, lymphocyte count, NLR, and PLR. When stratified by ASDAS levels, patients with HAD and VHDA had significantly different Hb, HCT, MCHC, NLR, PLR, ESR, and CRP compared to those with inactive disease or LDA. Conclusion: The study highlights significant hematological and inflammatory differences between AS patients and controls, emphasizing the utility of markers such as NLR, PLR, and CRP in assessing disease activity. Stratification by ASDAS levels further demonstrates that patients with high and very high disease activity exhibit more pronounced alterations in these parameters, underscoring their potential role in monitoring disease severity and guiding management strategies.